强化降脂治疗对急性缺血性脑卒中预后的影响

Effect of Intensive Lipid-Lowering Therapy on the Prognosis of Acute Ischemic Stroke

目的探讨强化降脂治疗在急性缺血性脑卒中患者中的应用价值。方法选择2018年9月—2019年9月我院收治的急性缺血性脑卒中患者80例,随机分为强化降脂组(n=40)与常规降脂组(n=40)。比较两组治疗前后低密度脂蛋白(low-density lipoprotein cholesterol,LDL-C),高敏C反应蛋白(high sensitive C reaction protein,hs-CRP)及金属基质蛋白9(matrix metalloprotein-9,MMP-9)水平、卒中量表(NIH Stroke Scale,NIHSS)评分及预后。结果治疗前,两组LDL-C、hs-CRP及MMP-9水平差异无统计学意义(P>0.05);治疗3个月后,两组LDL-C、hs-CRP及MMP-9水平有所下降,且强化降脂组下降明显(P<0.05)。治疗3个月后,两组的NIHSS评分有所降低,且强化降脂组降幅大(P<0.05)。随访3个月两组患者的全因死亡率及预后不良比率差异无统计学意义(P>0.05),强化降脂组患者脑卒中复发率低于常规降脂组,但差异无统计学意义(P>0.05)。两组治疗过程中不良反应比较差异无统计学意义(P>0.05)。结论强化降脂治疗3个月能明显改善急性缺血性脑卒中患者预后。

Objective To explore the application value of intensive lipidlowering therapy in patients with acute ischemic stroke.Methods 80 patients with acute ischemic stroke admitted to our hospital from September 2018 to September 2019 were randomly divided into intensive lipidlowering group(n=40)and conventional lipid-lowering group(n=40).The levels of low-density lipoprotein(LDL-C),high-sensitivity C-reaction protein(HS-CRP),matrix metalloproteinase-9(MMP-9),stroke scale(NIHSS)and prognosis were compared between the two groups before and after treatment.Results There was no significant difference in LDL-C,hs-CRP and MMP-9 levels between the two groups before treatment(P>0.05).After 3 months of treatment,LDL-C,hs-CRP and MMP-9 levels in the two groups decreased significantly,and the decrease was more obvious in the intensive lipid-lowering group(P<0.05).After 3 months of treatment,the NIHSS score of the two groups decreased significantly,and the intensive lipid-lowering group decreased even more(P<0.05).There was no significant difference in the rate of all-cause mortality and poor prognosis between the two groups after follow-up for 3 months(P>0.05),but the recurrence rate of stroke in the intensive lipid-lowering group was significantly lower than that in the conventional lipid-lowering group(P>0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion Intensive lipid-lowering therapy for 3 months can significantly improve the prognosis of patients with acute ischemic stroke.